Menopause: Scientific evidence changes prescribing practice—a comparison of the management of the climacteric and use of hormone replacement therapy among Swedish gynaecologists in 1996 and 2003
Article first published online: 5 DEC 2005
BJOG: An International Journal of Obstetrics & Gynaecology
Volume 113, Issue 1, pages 15–20, January 2006
How to Cite
Thunell, L., Milsom, I., Schmidt, J. and Mattsson, L.-Å. (2006), Menopause: Scientific evidence changes prescribing practice—a comparison of the management of the climacteric and use of hormone replacement therapy among Swedish gynaecologists in 1996 and 2003. BJOG: An International Journal of Obstetrics & Gynaecology, 113: 15–20. doi: 10.1111/j.1471-0528.2005.00805.x
- Issue published online: 5 DEC 2005
- Article first published online: 5 DEC 2005
- Accepted 28 September 2005.
Objectives To study changes in attitudes, knowledge and management strategies concerning hormone replacement therapy (HRT) among gynaecologists in Sweden.
Design Comparative questionnaire study.
Setting National survey.
Population Practising gynaecologists.
Methods In 1996, gynaecologists in Sweden (n= 1323) were invited to return a postal questionnaire concerning their attitudes, knowledge and management strategies concerning HRT. They were also asked about their own use of HRT. In 2003, a similar questionnaire was sent to practising gynaecologists (n= 1320) in Sweden.
Main outcome measures Attitudes to and personal use of HRT.
Results The response rate was 76% in 2003 when 11% of the gynaecologists thought that all women without contraindications should be offered HRT compared with 44% in 1996 and 89% found it difficult to evaluate pros and cons with HRT in a clinical situation (74% in 1996). More gynaecologists in 2003 believed that HRT increased the risk for breast cancer (95% vs 71%). Twenty-five percent in 2003 stated that risk factors for osteoporosis were absolute indications for HRT (60% in 1996). Current ischaemic heart disease was considered to be an indication for HRT by 7% in 2003 (60% in 1996). In 2003, current use of HRT was reported by 71% of female menopausal gynaecologists (88% in 1996).
Conclusions Swedish gynaecologists were more cautious in their management strategies concerning HRT in 2003 compared with 1996, probably influenced by results from the Heart and Estrogen/Progestin Replacement Study (HERS) and Women's Health Initiative (WHI) studies. Current use of HRT was still high among female gynaecologists, although it had decreased since 1996.